Dr. Ravi Teja Rudraraju

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Complex Knee Surgery

Multi-ligament Knee Injury

A multi-ligament knee injury is a complex condition that occurs when more than one ligament within the knee is damaged. The primary knee ligaments affected are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL). Such injuries commonly result from events like knee dislocation, major accidents, or traumatic sporting falls.

While rare, multi-ligament injuries require specialized care. Complex knee surgery, particularly multi-ligament knee surgery, is intricate and typically necessitates the expertise of a knee specialist who routinely performs such procedures.

Description of Complex Knee Surgery

Except for combined ACL and MCL injuries, almost all two-ligament knee injuries require combined surgical reconstruction. Dr. Ravi Teja recommends conducting multiple ligament reconstruction in a single setting. This approach is crucial as each ligament depends on others for overall stability. Performing reconstruction for only part of the injury increases the risk of the reconstructed ligament stretching out over time. Dr. Ravi Teja’s surgical team is equipped to streamline the procedure, ensuring it doesn’t unduly prolong the patient’s time under anesthesia. It’s strongly advised that patients undergo multi-ligament knee surgery in one session to expedite their rehabilitation and return to normal life.

Post-Operative Protocol for Complex Knee Surgery

Following complex knee surgery, postoperative rehabilitation is absolutely crucial for optimal outcomes. Even with a successful multi-ligament reconstruction, without a comprehensive rehabilitation program, the results may not be as desired. Therefore, at drraviteja.com, we emphasize the importance of starting physical therapy the day after surgery. Immediate focus is placed on restoring range of motion and reactivating muscles. Direct communication between Dr. Ravi Teja and the physical therapist is prioritized to enhance patient outcomes. This approach leads to improved overall results, reduced joint stiffness, and faster restoration of muscle function.

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Frequently Asked Questions

A multiligament reconstruction involves the surgical reconstruction of two or more of the four ligaments surrounding the knee. The primary ligaments typically addressed are the ACL, PCL, MCL, and LCL. While additional ligaments on the medial and lateral sides of the knee may also be reconstructed, the general understanding of multiligament reconstruction is that at least two of these four areas are addressed during the procedure.

The rehabilitation program for multiligament reconstruction is focused on preventing knee stiffness, avoiding graft stretching, and promoting overall lower extremity strength. A standard program, supported by peer-reviewed literature, begins with range of motion exercises starting on the first day post-surgery, gradually progressing to weightbearing around the six-week mark, and advancing to a structured strengthening regimen thereafter. This approach has become the new standard of care for facilitating a return to high-level activities following multiligament reconstruction.

Generally, the recovery period for multiligament reconstructions spans between nine and twelve months to resume full activities. During the initial six weeks, emphasis is placed on achieving motion, often with patients being nonweightbearing to allow for graft healing. Following this period, a progressive strengthening program is implemented. Between five and six months postoperatively, stress radiographs are typically conducted to assess graft healing and determine if patients can increase their activity levels. Notably, individuals undergoing PCL reconstruction may require a slower rehabilitation pace to safeguard against graft stretching. This involves utilizing a dynamic knee brace tailored for PCL reconstructions and implementing a more gradual rehabilitation program to optimize healing before engaging in impact or rotational activities.

 
 
 
 
 

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